Bone Formation by Revascularized Periosteal and Bone Grafts, Compared With Traditional Bone Grafts

Puckett, Charles L.; Hurvitz, James S.; Metzler, Michael H.; Silver, Donald

doi:10.1097/00006534-197909000-00013

Cited by 82 publications

(23 citation statements)

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“…As evidenced by intravital microscopy, angiogenesis precedes osteogenesis (Albrektsson andAlbrektsson 1978, Albrektsson 1980), representing an important event for the viability and incorporation of bone (Burchardt 1987). Experimental studies have shown that rapidly vascularized bone grafts retain their viability and demonstrate improved incorporation (Puckett et al 1979). To date, the potential contribution of donor-derived microvessels for the viability and incorporation of bone grafts has not been addressed.…”

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confidence: 99%

Potential role of pre-existing blood vessels for vascularization and mineralization of osteochondral graftsAn intravital microscopic study in mice

Rothenfluh

Demhartner

Fraitzl

et al. 2004

Acta Orthopaedica Scandinavica

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Background The aim of this study was to develop an experimental model that allows to elude the potential role of the preexisting graft microvasculature for vascularization and mineralization of osteochondral grafts.Animals and methods For that purpose, the II-IV metatarsals of fetal DDY-mice known to be nonvascularized at day 16 of gestation (M16) but vascularized at day 18 (M18) were freshly transplanted into dorsal skin fold chambers of adult DDY mice. Using intravital microscopy angiogenesis, leukocyte-endothelium interaction and mineralization were assessed for 12 days.Results Angiogenesis occurred at 32 hours in M18, but not before 57 hours in M16 (p = 0.002), with perfusion of these vessels at 42 hours (p = 0.005) and 65 hours (p = 0.1), respectively. Vessels reached a density three times as high as that of the recipient site at day 6, remaining constant until day 12 in M18, whereas in M16 vascular density increased from day 6 and reached that of M18 at day 12 (p = 0.04). Leukocyte-endothelium interaction showed sticker counts elevated by a factor of 4-5 in M18 as compared to M16. Mineralization of osteochondral grafts did not differ between M16 and M18, which significantly increased in both groups throughout the observation period.Interpretation We propose the faster kinetics in the angiogenic response to M18 and the elevated counts of sticking leukocytes to rest on the potential of establishing end-to-end anastomoses (inosculation) of the vascularized graft with recipient vessels.

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confidence: 99%

Potential role of pre-existing blood vessels for vascularization and mineralization of osteochondral graftsAn intravital microscopic study in mice

Rothenfluh

Demhartner

Fraitzl

et al. 2004

Acta Orthopaedica Scandinavica

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“…We found no clear source in our systematic review supporting the idea that grafts longer than 6 cm need to be vascularized. The four articles that compared VBGs and NVBGs between 1975 and 1983 were all animal studies that made no comparison of graft length and were excluded [5,17,29,36]. The earliest reference that VBGs ''offer significant advantages over conventional treatment methods in selected patients with segmental bone defects greater than 6 cm'' [53] from an article describing 41 VBGs for tumors and trauma in the extremities, therefore is not based on studies that compare VBGs and NVBGs…”

Section: Resultsmentioning

confidence: 99%

“…The articles (n = 725) were screened and excluded (n = 721) if there was no comparison between VBGs and NVBGs. Full-text was obtained for the remaining articles (n = 4) [5,17,29,36] and those with no comparison of graft length were excluded (n = 4). There were no articles that met the inclusion criteria.…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

Vascularized versus Nonvascularized Bone Grafts: What Is the Evidence?

Allsopp

Hunter-Smith

Rozen

2016

Clinical Orthopaedics &Amp; Related Research

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Background There is a general perception in practice that a vascular supply should be used when large pieces of bone graft are used, particularly those greater than 6 cm in length for long-bone and large-joint reconstructions. However, the scientific source of this recommendation is not clear. Questions/purposes We wished to perform a systematic review to (1) investigate the origin of evidence for this 6-cm rule, and (2) to identify whether there is strong evidence to support the importance of vascularization for longer grafts and/or the lack of vascularization for shorter grafts. Methods Two systematic reviews were performed using SCOPUS and Medline, one for each research question. For

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“…Some evidence has been pre sented that periosteal grafts, taken from dif ferent donor sites, have different qualities [2,11], This was the reason why two different types of revascularized periosteal grafts were tested. Recently, two experiments have been performed on revascularizing periosteal grafts [3,8]. Both concerned the rib as a donor site, and both were done in dogs.…”

Section: Discussionmentioning

confidence: 99%